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. 2023 Aug;63(4):499-508.
doi: 10.1111/ajo.13626. Epub 2022 Oct 25.

Grouping women of South Asian ethnicity for pregnancy research in New Zealand

Esti De Graaff  1 , Lynn Sadler  1   2 , Heena Lakhdhir  3 , Rachel Simon-Kumar  4 , Roshini Peiris-John  5 , Wendy Burgess  1 , Karaponi Okesene-Gafa  1   3 , Robin Cronin  1   3 , Lesley Mccowan  1 , Ngaire Anderson  1
Affiliations

Grouping women of South Asian ethnicity for pregnancy research in New Zealand

Esti De Graaff et al. Aust N Z J Obstet Gynaecol. 2023 Aug.

Abstract

Background: The New Zealand (NZ) Ministry of Health ethnicity data protocols recommend that people of South Asian (SAsian) ethnicity, other than Indian, are combined with people of Japanese and Korean ethnicity at the most commonly used level of aggregation in health research (level two). This may not work well for perinatal studies, as it has long been observed that women of Indian ethnicity have higher rates of adverse pregnancy outcomes, such as perinatal death. It is possible that women of other SAsian ethnicities share this risk.

Aims: This study was performed to identify appropriate groupings of women of SAsian ethnicity for perinatal research.

Materials and methods: National maternity and neonatal data, and singleton birth records between 2008 and 2017 were linked using the Statistics NZ Integrated Data Infrastructure. Socio-demographic risk profiles and pregnancy outcomes were compared between 15 ethnic groups. Recommendations were made based on statistical analyses and cultural evaluation with members of the SAsian research community.

Results: Similarities were observed between women of Indian, Fijian Indian, South African Indian, Sri Lankan, Bangladeshi and Pakistani ethnicities. A lower-risk profile was seen among Japanese and Korean mothers. Risk profiles of women of combined Indian-Māori, Indian-Pacific and Indian-New Zealand European ethnicity more closely represented their corresponding non-Indian ethnicities.

Conclusions: Based on these findings, we suggest a review of current NZ Ministry of Health ethnicity data protocols. We recommend that researchers understand the risk profiles of participants prior to aggregation of groups in research, to mitigate risks associated with masking differences.

Keywords: Asia; New Zealand; Western; ethnicity; pregnancy complications; risk factors.

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Figures

Figure 1
Figure 1
Total number of births by ethnicity, between 2008 and 2017 in New Zealand.
Figure 2
Figure 2
Gestational diabetes rates by body mass index category and ethnicity. Count (N) per body mass index category by ethnicity in Table 1.
See this image and copyright information in PMC

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